The influence of special environment on peripheral veins and coping strategies during the space medical rescue mission of Shenzhou-13 spacecraft / 中华急诊医学杂志

Objective:To study the environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft, evaluate the influence of special environment on peripheral veins, and investigate the coping strategies.Methods:Combined with the practice of launch section during space medical rescue mission of Shenzhou-13 spacecraft, the main factors of aerospace special environment, cold and faint light, were selected and the related literature was reviewed to explore the feasibility, advantages and disadvantages of peripheral venipuncture, central venous catheter and bone marrow puncture. The experience of the space medical rescue mission was summarized and the coping strategies were provided for follow-up task training.Results:The environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft included cold, faint light, sand-wind and complex terrain. The vascular filling, vascular elasticity and visibility of peripheral vein decreased in different degrees under special environmental, the vascular visibility was most affected. The literature analysis showed that bone marrow puncture was a suitable method to establish infusion access in cold and faint light environment.Conclusions:The special environment of space launch mission has greater impact on peripheral veins. In order to assurance the successful implementation of manned space project, the training of basic operational skills should be consolidated, the training of ability in special environment should be enhanced and the advanced clinical auxiliary equipment should be equipped in follow-up space medical mission training.

Epidemiological investigation on a visceral leishmaniasis case in Zhengzhou City of Henan Province / 中国血吸虫病防治杂志

Objective To perform an epidemiological investigation on a case with visceral leishmaniasis in Zhengzhou City, Henan Province, and to identify the source of infection, so as to illustrate the transmission chain and assess the risk of local leishmaniasis transmission. Methods The medical data were collected from a case with visceral leishmaniasis in Zhengzhou City, and the patient’s bone marrow smears were detected by microscopy. Serum anti-Leishmania antibody test and PCR assay were performed among high-risk residents and all dogs in the village where the patient lived. Sandflies were captured using light traps and artificial traps, and the captured female Phlebotomus chinensis was subjected to PCR assay. The internal transcribed spacer 1 (ITS1) gene was amplified with a nested PCR assay using the genomic DNA extracted from visceral leishmaniasis patients, positive dogs and sandflies, and the sequences were aligned with those download from NCBI. In addition, a phylogenetic tree was created based on the ITS1 gene. Results The visceral leishmaniasis patient had recurrent irregular fever, reduced complete blood counts, low hemoglobin, and a large number of Leishmania amastigotes in bone marrow smears, and was therefore diagnosed as visceral leishmaniasis. Both rk39 rapid diagnostic test and PCR assay tested negative among 324 residents living neighboring the patient’s residence, while 21.39% (43/201) dogs were positive for rk39 rapid diagnostic test and 13.93% (28/201) positive for PCR assay. There were 17 female Ph. chinensis tested positive for Leishmania (0.82%) by PCR assay, and the ITS gene sequences from visceral leishmaniasis patients, positive dogs and sandflies shared a 100% homology with L. infantum. The Leishmania species was therefore characterized as L. infantum. Conclusions L. infantum infection occurs in visceral leishmaniasis patients, dogs and sandflies in Zhengzhou City, indicating a complete transmission chain and a high transmission risk of visceral leishmaniasis by L. infantum. Intensified control measures are required to prevent local transmission of leishmaniasis in Zhengzhou City.

Value of 18F-FDG uptake features in differential diagnosis of benign and malignant solitary pulmonary lesions / 中华核医学与分子影像杂志

Objective:To evaluate the value of 18F-FDG uptake features in differential diagnosis of benign and malignant solitary pulmonary lesions. Methods:A total of 274 patients (181 males, 93 females, age: (61.0±10.2) years) with solitary pulmonary lesions who underwent 18F-FDG PET/CT between September 2010 and March 2017 were retrospectively analyzed. The 18F-FDG uptake features of lesions were divided into 5 types: full uptake (Group A), circular uptake (Group B), multi-focus uptake (Group C), mild uptake (Group D) and no-uptake (Group E). According to the pathology or follow-up results, the incidences of benign and malignant lesions in each group were analyzed. The diagnostic efficiencies of 18F-FDG uptake feature classification(A+ B=malignancy, C+ D+ E=benign) and SUV method (lesions with SUV max≥2.5 was taken as the malignancy) were calculated. χ2 test and ROC curve were used to analyze the data. Results:The malignant incidences of Groups A-E were 86.25%(138/160), 71.05%(27/38), 31.25%(10/32), 43.48%(10/23) and 14.29%(3/21), respectively ( χ2=79.49, P<0.001), and the rate of Group A was the highest ( χ2 values: 5.11-55.84, all P<0.05). There were significant differences in the malignancy incidence between A+ B group and C+ D+ E group (83.33%(165/198) vs 30.26%(23/76)), and between SUV max≥2.5 group and SUV max<2.5 group (76.09%(175/230) vs 29.55%(13/44); χ2 values: 71.83 and 37.15, both P<0.001). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the 18F-FDG uptake feature classification and the SUV method were 87.77%(165/188) vs 93.09%(175/188), 61.63%(53/86) vs 36.05%(31/86), 79.56%(218/274) vs 75.18%(206/274), 83.33%(165/198) vs 76.09%(175/230), 69.74%(53/76) vs 70.45%(31/44), respectively. ROC curve analysis showed that the diagnostic accuracy of the 18F-FDG uptake feature classification was higher than that of SUV method (AUCs: 0.747, 0.646; Z=4.05, P<0.001). Conclusions:18F-FDG uptake feature classification can improve the diagnostic specificity and accuracy of solitary pulmonary lesions. The multi-focus uptake feature maybe a sign of benign lesions, which still needs more researches to confirm.

Discussion on key points in the diagnosis and treatment of infant traumatic brain injury / 中华创伤杂志

The diagnosis and treatment of infant traumatic brain injury (TBI) are different from adults due to their particular physiological structure and neurological function as well as disability to cooperate in physical examination. However, the relevant clinical guidelines in the dignosis and treatment of TBI in infant patients were rare in our nation because of the low incidence and lack of relative researches. Most of the infant patients tend to be treated as adults, which may not only lead to false or missed diagnoses, but also bring about unnecessary examination or treatment risks. As a result, the therapeutic efficiency may be affected. In this paper, the author explores the characteristics in the diagnosis and treatment of infant TBI and the therapeutic principles in order to improve the therapeutic efficiency of infant TBI.

Metformin and lipopolysaccharide regulate transcription of NFATc2 gene via the transcription factor RUNX2 / 南方医科大学学报

OBJECTIVE@#To construct a luciferase reporter gene vector carrying human nuclear factor of activated T cells 2 (NFATc2) gene promoter and examine the effects of metformin and lipopolysaccharide (LPS) on the transcriptional activity of NFATc2 gene.@*METHODS@#The promoter sequence of human NFATc2 gene was acquired from UCSC website for PCR amplification. NFATc2 promoter fragment was inserted into pGL3-basic plasmid double cleaved with Kpn Ⅰ and Hind Ⅲ. The resultant recombinant plasmid pGL3-NFATC2-promoter was co-transfected with the internal reference plasmid pRL-TK in 293F cells, and luciferase activity in the cells was detected. Reporter gene vectors of human NFATc2 gene promoter with different fragment lengths were also constructed and assayed for luciferase activity. The changes in transcription activity of NFATc2 gene were assessed after treatment with different concentrations of metformin and LPS for 24 h. We also examined the effect of mutation in RUNX2-binding site in NFATC2 gene promoter on the regulatory effects of metformin and LPS on NFATc2 transcription.@*RESULTS@#We successfully constructed pGL3-NFATc2-promoter plasmids carrying different lengths (2170 bp, 2077 bp, 1802 bp, 1651 bp, 1083 bp, 323 bp) of NFATc2 promoter sequences as verified by enzymatic digestion and sequencing. Transfection of 293F cells with the plasmid carrying a 1651 bp NFATc2 promoter (pGL3-1651 bp) resulted in the highest transcriptional activity of NFATc2 gene, and the luciferase activity was approximately 3.3 times that of pGL3-2170 bp (1.843 ± 0.146 vs 0.547 ± 0.085). Moderate (5 mmol/L) and high (10 mmol/L) concentrations of metformin significantly upregulated the transcriptional activity of pGL3-1651 bp by up to 2.5 and 3 folds, respectively. LPS at different doses also upregulated the transcriptional activity of pGL3-1651 bp by at least 1.6 folds. The mutation in the RUNX2 binding site on pGL3-1651 bp obviously reduced metformin- and LPS-induced enhancement of pGL3-1651bp transcription by 1.7 and 2 folds, respectively.@*CONCLUSION@#pGL3-NFATc2-promoter can be transcribed and activated in 293F cells, and LPS and metformin can activate the transcription of pGL3- NFATc2-promoter in a RUNX2-dependent manner.

Effects of exosomes from human adipose-derived mesenchymal stem cells on pulmonary vascular endothelial cells injury in septic mice and its mechanism / 中华烧伤杂志

Objective: To investigate the effects of exosomes from human adipose-derived mesenchymal stem cells (ADSCs) on pulmonary vascular endothelial cells (PMVECs) injury in septic mice and its mechanism. Methods: The experimental research method was adopted. The primary ADSCs were isolated and cultured from the discarded fresh adipose tissue of 3 patients (female, 10-25 years old), who were admitted to the First Affiliated Hospital of Air Force Medical University undergoing abdominal surgery, and the cell morphology was observed by inverted phase contrast microscope on the 5th day. The expressions of CD29, CD34, CD44, CD45, CD73, and CD90 of ADSCs in the third passage were detected by flow cytometry. The third to the fifth passage of ADSCs were collected, and their exosomes from the cell supernatant were obtained by differential ultracentrifugation, and the shape, particle size, and the protein expressions of CD9, CD63, tumor susceptibility gene 101 (TSG101), and β-actin of exosomes were detected, respectively, by transmission electron microscopy, nano-particle tracking analysis and Western blotting. Twenty-four adult male BALB/c mice were adopted and were divided into normal control group, caecal ligation perforation (CLP) alone group, and CLP+ADSC-exosome group with each group of 8 according to random number table (the same grouping method below) and were treated accordingly. At 24 h after operation, tumor necrosis factor (TNF-α) and interleukin 1β (IL-1β) levels of mice serum were detected by enzyme-linked immunosorbent assay, and lung tissue morphology of mice was detected by hematoxylin-eosin and myeloperoxidase staining, and the expression of 8-hydroxy-deoxyguanosine (8-OHdG) of mouse lung cells was detected by immunofluorescence method. Primary PMVECs were obtained from 1-month-old C57 mice regardless gender by tissue block method. The expression of CD31 of PMVECs was detected by immunofluorescence and flow cytometry. The third passage of PMVECs was co-cultured with ADSCs derived exosomes for 12 h, and the phagocytosis of exosomes by PMVECs was detected by PKH26 kit. The third passage of PMVECs were adopted and were divided into blank control group, macrophage supernatant alone group, and macrophage supernatant+ADSC-exosome group, with 3 wells in each group, which were treated accordingly. After 24 h, the content of reactive oxygen species in cells was detected by flow cytometry, the expression of 8-OHdG in cells was detected by immunofluorescence, and Transwell assay was used to determine the permeability of cell monolayer. The number of samples in above were all 3. Data were statistically analyzed with one-way analysis of variance and least significant difference t test. Results: The primary ADSCs were isolated and cultured to day 5, growing densely in a spindle shape with a typical swirl-like. The percentages of CD29, CD44, CD73 and CD90 positive cells of ADSCs in the third passage were all >90%, and the percentages of CD34 and CD45 positive cells were <5%. Exosomes derived from ADSCs of the third to fifth passages showed a typical double-cavity disc-like structure with an average particle size of 103 nm, and the protein expressions of CD9, CD63 and TSG101 of exosomes were positive, while the protein expression of β-actin of exosomes was negative. At 24 h after operation, compared with those in normal control group, both the levels of TNF-α and IL-1β of mice serum in CLP alone group were significantly increased (with t values of 28.76 and 29.69, respectively, P<0.01); compared with those in CLP alone group, both the content of TNF-α and IL-1β of mice serum in CLP+ADSC-exosome group was significantly decreased (with t values of 9.90 and 4.76, respectively, P<0.05 or P<0.01). At 24 h after surgery, the pulmonary tissue structure of mice in normal control group was clear and complete without inflammatory cell infiltration; compared with those in normal control group, the pulmonary tissue edema and inflammatory cell infiltration of mice in CLP alone group were more obvious; compared with those in CLP alone group, the pulmonary tissue edema and inflammatory cell infiltration of mice in CLP+ADSC-exosome group were significantly reduced. At 24 h after operation, endothelial cells in lung tissues of mice in 3 groups showed positive expression of CD31; compared with that in normal control group, the fluorescence intensity of 8-OHdG positive cells of the lung tissues of mice in CLP alone group was significantly increased, and compared with that in CLP alone group, the fluorescence intensity of 8-OHdG positive cells in the lung tissues of mice in CLP+ADSC-exosome group was significantly decreased. The PMVECs in the 3rd passage showed CD31 positive expression by immunofluorescence, and the result of flow cytometry showed that CD31 positive cells accounted for 99.5%. At 12 h after co-culture, ADSC-derived exosomes were successfully phagocytose by PMVECs and entered its cytoplasm. At 12 h after culture of the third passage of PMVECs, compared with that in blank control group, the fluorescence intensity of reactive oxygen species of PMVECs in macrophage supernatant alone group was significantly increased (t=15.73, P<0.01); compared with that in macrophage supernatant alone group, the fluorescence intensity of reactive oxygen species of PMVECs in macrophage supernatant+ADSC-exosome group was significantly decreased (t=4.72, P<0.01). At 12 h after culture of the third passage of PMVECs, and the 8-OHdG positive fluorescence intensity of PMVECs in macrophage supernatant alone group was significantly increased; and compared with that in blank control group, the 8-OHdG positive fluorescence intensity of PMVECs in macrophage+ADSC-exosome supernatant group was between blank control group and macrophage supernatant alone group. At 12 h after culture of the third passage PMVECs, compared with that in blank control group, the permeability of PMVECs monolayer in macrophage supernatant alone group was significantly increased (t=6.34, P<0.01); compared with that in macrophage supernatant alone group, the permeability of PMVECs monolayer cells in macrophage supernatant+ADSC-exosome group was significantly decreased (t=2.93, P<0.05). Conclusions: Exosomes derived from ADSCs can ameliorate oxidative damage in mouse lung tissue, decrease the level of reactive oxygen species, 8-OHdG expression, and permeability of PMVECs induced by macrophage supernatant.

Whole exome sequencing and analysis of hypohidrotic ectodermal dysplasia patients / 中华口腔医学杂志

Objective: To detect gene mutation in patients with hypohidrotic ectodermal dysplasia (HED) by using whole exome sequencing, to analyze the pathogenicity of the mutations, and to provide reference for the genetic diagnosis of HED patients. Methods: Peripheral blood genomic DNA was extracted from each of the HED patients and their family members collected in Peking University School and Hospital of Stomatology from August 2016 to August 2021. Whole exome sequencing and sanger sequencing were performed to detect gene mutations. Functions of the rare variants after the database filtering were analyzed by bioinformatics tools. Results: Three reported mutations of ectodysplasin A (EDA) gene (c.2T>C, c.161A>G, c.467G>A) and a mutation of ectodysplasin A receptor (EDAR) gene (c.871G>A) were detected by whole genome sequencing in four HED patients, and were verified by Sanger sequencing in four HED families. The EDAR gene mutation founded in this research was reported in HED patients for the first time. Bioinformatics tools predicted that the mutations of EDA gene detected in this study were highly species conserved and disease-causing. The combined annotation dependent depletion (CADD) scores of EDA gene mutations c.2T>C, c.161A>G and c.467G>A were 22.5, 26.3 and 25.5 respectively, and the genomic evolutionary rate profiling (GERP) scores were 2.16, 2.26 and 2.18 respectively. The EDAR gene mutation c.871G>A detected in this study was species conserved and possibly disease-causing. The CADD and GERP scores of EDAR gene mutation c.871G>A were 22.0 and 1.93 respectively. Conclusions: Three reported mutations of EDA gene and a previously unreported mutation of EDAR gene were detected in four HED families. Different mutations of EDA gene and EDAR gene could make different influence on the protein function and lead to the occurrence of HED.

Retrospective analysis of infliximab in the treatment of Kawasaki disease / 中华儿科杂志

Objective: To investigate the efficacy and safety of infliximab (IFX) therapy for children with Kawasaki disease. Methods: Sixty-eight children with Kawasaki disease who received IFX therapy in Children's Hospital of Fudan University from January 2014 to April 2021 were enrolled. The indications for IFX administration, changes in laboratory parameters before and after IFX administration, response rate, drug adverse events and complications and outcomes of coronary artery aneurysms (CAA) were retrospectively analyzed. Comparisons between groups were performed with unpaired Student t test or Mann-Whitney U test or chi-square test. Results: Among 68 children with Kawasaki disease, 52 (76%) were males and 16 (24%) were females. The age of onset was 2.1 (0.5, 3.8) years. IFX was administered to: (1) 35 children (51%) with persistent fever who did not respond to intravenous immunoglobulin (IVIG) or steroids, 28 of the 35 children (80%) developed CAA before IFX therapy; (2) 32 children (47%) with continuous progression of CAA; (3) 1 child with persistent arthritis. In all cases, IFX was administered as an additional treatment (the time from the onset of illness to IFX therapy was 21 (15, 30) days) which consisted of second line therapy in 20 (29%), third line therapy in 20 (29%), and fourth (or more) line therapy in 28 (41%). C-reactive protein (8 (4, 15) vs. 16 (8, 43) mg/L, Z=-3.38, P=0.001), serum amyloid protein A (17 (10, 42) vs. 88 (11, 327) mg/L, Z=-2.36, P=0.018) and the percentage of neutrophils (0.39±0.20 vs. 0.49±0.21, t=2.63, P=0.010) decreased significantly after IFX administration. Fourteen children (21%) did not respond to IFX and received additional therapies mainly including steroids and cyclophosphamide. There was no significant difference in gender, age at IFX administration, time from the onset of illness to IFX administration, the maximum coronary Z value before IFX administration, and the incidence of systemic aneurysms between IFX-sensitive group and IFX-resistant group (all P>0.05). Infections occurred in 11 cases (16%) after IFX administration, including respiratory tract, digestive tract, urinary tract, skin and oral infections. One case had Calmette-Guérin bacillus-related adverse reactions 2 months after IFX administration. All of these adverse events were cured successfully. One child died of CAA rupture, 6 children were lost to follow up, the remaining 61 children were followed up for 6 (4, 15) months. No CAA occurred in 7 children before and after IFX treatment, while CAA occurred in 54 children before IFX treatment. CAA regressed in 23 (43%) children at the last follow-up, and the diameter of coronary artery recovered to normal in 10 children. Conclusion: IFX is an effective and safe therapeutic choice for children with Kawasaki disease who are refractory to IVIG or steroids therapy or with continuous progression of CAA.

Clinicopathologic features and prognosis of appendendicular goblet cell adenocarcinoma / 中华普通外科杂志

Objective:To investigate the clinicopathological characteristics, and prognosis of appendiceal goblet cell adenocarcinoma(GCA).Methods:The clinical and pathological data of 21 GCA cases were retrospectively analyzed, and their pathological morphology, immunohistochemical phenotype, genetic alteration and clinical treatment and prognosis were studied.Results:Most of the 21 patients showed appendicitis, with appendectomy alone or extensive resection of the tumor, followed by chemotherapy. There were 12 low-grade and 9 moderate and high-grade patients by pathological examination, and tumor cells express CEA, CK20, SATB-2, Syn(19/21), CgA(18/21), CD56(18/21), Ki67(+,10%-50%),and one patient had mutations in the BRAF gene.Depth of tumor infiltration ( r=0.716, P<0.001), and TNM stage ( r=0.816, P<0.001) were all positively correlated with the grade of GCA. After 19 to 98 months of follow-up, one patient relapsed and one patient died. Conclusions:Appendiceal GCA is a kind of tumor with bidirectional differentiation characteristics. Its morphology and biological behavior lineage are relatively broad, especially the high level is more aggressive, hence more active treatment should be adopted.

Multi-department cooperation in prevention and control of multi-drug-resistant bacteria nosocomial infectionata hospital / 公共卫生与预防医学

Objective To explore the role of multi-department cooperation in the prevention and control of nosocomial infection of multi-drug-resistant bacteria(MDRO). Methods Theretrospective analysis was conducted on 1 478 inpatients before the implementation of multi-department cooperative management (January 2019 to December 2019). The implementation of multi-department cooperative management began in January 2020, including :(1) the establishment of multi-department cooperative management organization system; (2) Establish a three-level MANAGEMENT network of MDRO; (3) Multidisciplinary joint training; (4) Clinical departments shall be equipped with clinical pharmacists; (5) The hospital infection monitoring system was used to conduct real-time monitoring on the submission of microbial samples, the detection rate of MDRO, the changes of drug-resistant bacteria and the use of antibiotics; (6) Led by the department of hospital pathology and medical Service, regular joint ward rounds should be conducted in the departments and key departments with high DETECTION rate of MDRO; (7) PDCA cycle mode was adopted for quality control of all links of nosocomial infection prevention and control measures; After the implementation of multi-department cooperative management (January 2020 to December 2020), all the hospitalized patients in 1849 cases were detected and counted, and the incidence of nosocomial infection, the detection rate of MDRO, the compliance rate of hand hygiene, the implementation rate of contact isolation, and the specimen inspection rate of therapeutic use of antibiotics and the reasonable utilization rate of antibiotics were compared before and after the implementation. Results The incidence of nosocomial infection and the detection rate of MDRO were significantly lower after the implementation of multi-department cooperative management than before (χ2=46.611, χ2=16.814, P 2 = 25.357, χ2=29.227, P2=25.576, χ2=33.624, P<0.05). Conclusion The practice of multi-department cooperative management brings into full play the advantages of interdisciplinary complementarity, improves the ability of medical staff to implement the prevention and control measures for MDRO, and can effectively reduce the incidence of nosocomial infection in MDRO.

Structure of Gardenia Blue Pigment and Its Inhibitory Activity on Monoamine Oxidase B / 中国实验方剂学杂志

ObjectiveTo study the chemical structure of gardenia blue pigment and its inhibitory activity against monoamine oxidase B （MAO-B）， in order to seek a potential feasible way for rational utilization and value enhancement of iridoids in Gardeniae Fructus. MethodIridoid glycosides in Gardeniae Fructus were hydrolyzed by cellulase to obtain their aglycones and reacted with amino acids. Then， the products were purified by column chromatography packed with D101 macroporous resin and preparative liquid chromatography to obtain gardenia blue pigments， and the gardenia blue pigments were identified by nuclear magnetic resonance （NMR） and mass spectrometry （MS）. Benzylamine was used as the reaction substrate of MAO-B and in vitro incubated with gardenia blue pigment monomers， high performance liquid chromatography （HPLC） was employed to determine the production of benzaldehyde for evaluating the inhibitory effect of gardenia blue pigments on MAO-B， the mobile phase was methanol （A） -50 mmol·L-1 potassium phosphate buffer （B， pH 3.2） （2∶3）， and the detection wavelength was 245 nm. ResultEight compounds of gardenia blue pigment A-H were synthesized and identified. In MAO-B inhibition test， compared with geniposide， the inhibitory activity of gardenia blue pigment D and E was significantly enhanced （P<0.05）. Compared with the 6β-hydroxygeniposide， the inhibitory activity of gardenia blue pigment G and H was significantly enhanced （P<0.05， P<0.01）. All the four gardenia blue pigments showed better MAO-B inhibitory activity than the prototype compounds. ConclusionGardenia blue pigment is a simple compound formed by one molecule of amino acid and one molecule of iridoid. Some gardenia blue pigments have better MAO-B inhibitory activity than the prototype compounds. The activity of gardenia blue pigment produced by different substrates is different， and the high-value gardenia blue pigment can be prepared based on experimental optimization， which can expand the application range of gardenia blue pigment and enrich the comprehensive utilization of iridoids from Gardeniae Fructus.

Epidemiological characteristics of norovirus infection in Lin’an District of Hangzhou City from 2012 to 2020 / 上海预防医学

ObjectiveTo determine the epidemiological characteristics of norovirus infections in Lin’an District， Hangzhou City from 2012 to 2020， and provide scientific evidence for improving preventive and control measures. MethodsDescriptive epidemiological methods were used to characterize the epidemic and conduct statistical analysis to determine related factors. ResultsA total of 37 clustered outbreaks of norovirus infection were reported in Lin’an District of Hangzhou from 2012 to 2020， including 8 outbreaks in kindergartens， 15 ones in elementary schools， 8 ones in middle and high schools， 2 ones in universities， and 4 other ones. The total number of cases with norovirus infection was 1 194， with the average attack rate of 3.76%. The incidence of norovirus was higher in winter and spring. It was also higher in urban areas， followed by suburban and mountainous areas neighbored to traffic lines. Moreover， attack rates differed significantly by transmission routes， including mixed contact and aerosol transmission， contact transmission， food-borne transmission， and water-borne transmission （χ2=186.91，P<0.001）. There was significant difference in the incidence among kindergartens， schools， and universities （χ2=980.15，P<0.001）. In the 37 outbreaks， norovirus were mainly classified as GⅡ in the 34 ones （accounting for 91.89%）， and GⅠ in the remaining 3 ones. ConclusionThe epidemic of norovirus infection in Lin’an District， Hangzhou City is characterized by certain population， time， space， transmission routes， and strains. It warrants enhanced health education and promotion， preparedness and response plan， syndromic surveillance， early alerting， school closure， and environmental disinfection for further prevention and control of norovirus infection.

Research progress of tumor microenvironmentally regulating organelle targeted drug delivery system / 药学学报

In recent years, the use of the body's immune system for anti-tumor immunotherapy has received extensive attention. However, the immunosuppressive tumor microenvironment (TME) limits the effect of immunotherapy. Therefore, overcoming the limitations of TME and immunosuppressive cells plays an important role in tumor immunotherapy. Nano agents have great potential to reprogram the immunosuppressive microenvironment and provide an effective strategy for immunotherapy. With the continuous development of active targeting nano carrier technology and the deepening of the research on drug action sites, subcellular organ targeting nano carrier materials with more accurate active targeting function have also attracted more and more attention. This review will briefly introduce the relationship between subcellular organelles and tumor, summarize the design strategy and research progress of targeted nano drug delivery system based on the characteristics of acidity, reactive oxygen species (ROS) activity, immunogenicity, and TME of immunosuppressive cells, to provide reference for the construction of subcellular pathway targeted drug delivery system in tumor immunotherapy.

Correlation and Influencing Factors of SUVmax and Ki-67 in Non-Hodgkin Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the influencing factors of maximum standard uptake value (SUVmax) of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and nuclear antigen Ki-67 in non-Hodgkin lymphoma (NHL) and their correlation.@*METHODS@#The relationship between SUVmax, Ki-67 and gender, age, maximum lesion diameter, extranodal involvement, superficial and deep lymph node involvement, malignancy, B symptoms, clinical stage, lactate dehydrogenase (LDH) and international prognostic index (IPI) scores and their correlation were reviewed.@*RESULTS@#Among 185 NHL patients, 99 cases were aggressive B-cell NHL, 43 cases were indolent B-cell NHL, and 43 cases were T-cell NHL, respectively. Obviously, the SUVmax and Ki-67 of aggressive B-cell NHL were higher than those of indolent B-cell NHL and T-cell NHL (P<0.05), while indolent B-cell NHL were lower than those of T-cell NHL (P<0.05). SUVmax and Ki-67 were closely related to maximum lesion diameter, extranodal involvement, malignancy, LDH, and IPI scores (P<0.05). SUVmax was positively correlated with Ki-67 expression (r=0.615). According to the analysis of receiver operating characteristic (ROC), the results showed that the SUVmax and Ki-67 could reflect the aggressiveness of NHL accurately, with an AUC of 0.871 and 0.968.@*CONCLUSION@#SUVmax and Ki-67 are not affected by age, sex, B symptoms, clinical stage and so on, and are relatively objective quantitative parameters. SUVmax is positively correlated with Ki-67 expression in NHL. SUVmax and Ki-67 have certain value in clinical diagnosis of malignant degree of NHL.

68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy / 亚洲男科学杂志(英文版)

To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.

Identification of specific peptides from Bubali Cornu by ultra-performance liquid chromatography-tandem mass spectrometry / 中国中药杂志

This paper explored the specific peptides from Bubali Cornu by ultra-performance liquid chromatography-tandem mass spectrometry and based on mathematics set theory. Following the profile analysis of peptides from Bubali Cornu, Bovis Grunniens Cornu, Caprae Hircus Cornu, and Suis Cornu by nano LC-LTQ-Obitrap-MS after digestion with trypsin, the relationship of peptide composition among different samples was analyzed using the mathematics set theory. The ones that existed only in the Bubali Cornu set rather than in any other set were considered as the specific peptides of Bubali Cornu. The further bioinformatic analysis revealed four specific peptides from Bubali Cornu, whose specificity was verified by UPLC-QQQ-MS. The results showed that these four peptides could be used for distinguishing Bubali Cornu from Caprae Hircus Cornu and Suis Cornu. This study has provided a rapid and simple method for seeking the specific peptides in animal medicines, which can be utilized for quality evaluation of animal medicines, thus making them authenticable and traceable.

Application of Diffusion Weighted Imaging in Pathological Grading/Typing and Clinical Staging of 95 Cases of Cervical Adenocarcinoma / 中国医学科学院学报

Objective To investigate the correlations of diffusion weighted imaging (DWI) with pathological grading,typing and clinical staging of cervical adenocarcinoma. Methods The data of 95 patients with cervical adenocarcinoma from May 2011 to February 2018 in Cancer Hospital Chinese Academy of Medical Sciences were collected for retrospective analysis.Before treatment,conventional MRI and DWI (b=0,800 s/mm2) were performed,and the apparent diffusion coefficient (ADC) value of cervical adenocarcinoma was measured.The ADC values were compared among different pathological grades,types,and clinical stages. Results The mean ADC value was (1.00±0.25)×10-3 mm2/s in the poorly differentiation group,(1.09±0.25)×10-3 mm2/s in the moderately differentiation group,and (1.22±0.20)×10-3 mm2/s in the well differentiation group,which showed significant difference between the poorly and well differentiation groups (P=0.002).The mean ADC values were (1.04±0.24) ×10-3 mm2/s and (1.21±0.26)×10-3 mm2/s in the endocervical adenocarcinoma (usual type) group and mucinous carcinoma group,respectively,which showed significant difference (P=0.005). Conclusions The worse differentiation of cervical adenocarcinoma corresponded to the lower ADC value.The ADC value of mucinous carcinoma was higher than that of endocervical adenocarcinoma (usual type).

Effects of Huaiqihuang Granules on airway inflammation in bronchiolitis / 中国基层医药

Objective:To investigate the effects of Huaiqihuang Granule on airway inflammation and wheezing reattack in bronchiolitis. Methods:A total of 120 patients with bronchiolitis presenting airway inflammation and wheezing reattack who received treatment in Zaozhuang Municipal Hospital and Yicheng Hospital of Traditional Chinese Medicine between January 2018 and October 2019 were included in this study. These patients randomly underwent either conventional treatment (control group, n = 60) or conventional treatment + Huaiqihuang Granule treatment (experimental group, n = 60). They received pulmonary function examinations and laboratory tests for evaluating serum and urinary inflammatory factors at admission and 2 months after discharge. They were followed up by telephone 3 months and 1 year after onset. Results:The ratio of time to reach the peak tidal expiratory flow over total expiratory time (TPTEF/TE) and the volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE) were significantly higher in the experimental group compared with those in the control group ( t = 3.13, 3.60, all P < 0.01). The ratio of tidal peak flow to tidal expiratory flow when 25% of tidal volume remains in the lungs (PF/TEF25) and functional residual capacity/kg (FRCp/kg) significantly decreased in the experimental group compared with those in the control group ( t = 3.88, 3.74, all P < 0.01). Interleukin-4 level and the ratio of interleukin-4/γ-interferon levels were significantly lower in the experimental group than in the control group ( t = 5.70, 8.93, all P < 0.01). Gamma-interferon level was significantly higher in the experimental group than in the control group ( t = 3.85, P < 0.01). There was no significant difference in urinary leukotriene E4 level post-treatment between the two groups ( t = 1.18, P > 0.05). The number of patients who had a wheezing attack again within 3 months post-treatment and the number of patients who had ≥3 wheezing attacks were significantly lower in the experimental group compared with those in the control group ( χ2 = 5.18, 6.98, P < 0.01 or 0.05). Conclusion:Huaiqihuang granule can effectively regulate the balance of the Th 1/Th 2 ratio, inhibit airway inflammation in bronchiolitis, improve pulmonary function, and reduce the number of wheezing reattacks.

Application status and thinking of acupuncture and moxibustion therapy for assisted reproductive field in the United States / 中国针灸

The application status of acupuncture and moxibustion therapy for assisted reproductive field in the United States was analyzed, and the existing problems and future development directions were discussed. According to the survey on the 456 websites of assisted reproductive clinic in the United States mentioned in the report of U.S. Centers for Disease Control and Prevention (CDC), 111 clinics among 456 assisted reproductive clinics recommend and used acupuncture and moxibustion therapy, accounting for 24.3%. Acupuncture and moxibustion therapy had obvious effect, good safety and low cost, and the assisted reproductive institutions in the United States had a high degree of application and recognition to acupuncture and moxibustion therapy. However, some problems, such as immature treatment scheme, unclear mechanism and imperfect insurance policies, still existed. In the future, the advantages of Chinese traditional acupuncture and moxibustion should combine with international modern assisted reproductive technology, and multi-center and large-sample clinical randomized controlled trials and basic experimental research on the mechanism of acupuncture and moxibustion for assisted reproduction should be carried out.

Collagen derived species-specific peptides for distinguishing donkey-hide gelatin (Asini Corii Colla) / 中草药·英文版

Objective: As an important food therapy product with traditional Chinese medicine (TCM) applications, donkey-hide gelatin (Asini Corii Colla, ACC) has been used for thousands of years. However, till now few effective strategy had been proposed to distinguish ACC from other animal hide gelatins, especially closely related horse- and mule-hide gelatins, which was an embarrassment of ACC quality control. Methods: Combined mass spectrometry and bioinformatic methods have been applied to identify and verify two ACC-specific peptides (Pep-1 and Pep-2) capable of distinguishing ACC from other closely related animal gelatins with high selectivity. Results: It confirmed that these two peptides could be not only used for distinguishing ACC from highly homologous horse-hide and mule-hide gelatins as well as other animal hide gelatins. Conclusion: The present study provides a simple method for species-specific peptides discovery, which can be used for assessing the quality of animal gelatin products, and ensure they are authenticable and traceable.